Duodenocutaneous fistula: An innovative management with triple tube drainage

Abstract

Treatment of duodenocutaneous fistula is an expensive and time-consuming proposition, but in the absence of complicating factors, 74% of these fistulas close over a 9–12-week period of time. When complicated with sepsis, distal obstruction, and biliary peritonitis, the cost of treatment and length of hospital stay are increased along with high mortality associated with it. We present a patient who was reoperated with a technique using 3 tube (gastrostomy, duodenostomy, and feeding jejunostomy) which enhanced his recovery and speedy discharge from hospital at a lesser cost compared to traditional methods of treatment. Managing high output enterocutaneous fistula is difficult. Our technique ameliorates the nutrition, improves the fluid and electrolyte balance, decreases the morbidity, and evades the mortality when compared to existing management methods in literature.

Keywords

• Duodenocutaneous fistula
• giant duodenal ulcer
• triple tube drainage
• triple tube ostomy